Electronic malignant bowel obstruction symptom monitoring smartphone application for patients with gynecologic cancers.

IF 4.1 2区医学 Q1 OBSTETRICS & GYNECOLOGY

International Journal of Gynecological Cancer Pub Date : 2024-10-07 DOI:10.1136/ijgc-2024-005490

Ainhoa Madariaga, Nazlin Jivraj, Pamela Soberanis Pina, Faiza Somji, Tran Truong, Sheena Melwani, Mike Lovas, Terri-Ann Gogos, Katrina Sajewycz, Gita Bhat, Husam Alqaisi, Eduardo Gonzalez-Ochoa, Ana Veneziani, Vikas Garg, Neesha C Dhani, Robert Grant, Valerie Bowering, Amit M Oza, Lisa Wang, Alejandro Berlin, Stephanie Lheureux

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引用次数: 0

Abstract

Objectives: Implementation of an interprofessional program at Princess Margaret Cancer Centre, including nurse-led proactive calls to support patients with gynecologic cancers with malignant bowel obstruction, demonstrated improved outcomes compared with historical controls. The aim of the study was to convert the proactive calls into an electronic monitoring program to assess it's feasibility and scalability in patients with gynecologic cancers with or at risk of malignant bowel obstruction.

Methods: 'My Bowels on Track' smartphone application included weekly/biweekly electronic patient-reported outcomes (PROs), educational materials, and a secure messaging system. Based on PRO answers, an alerting system flagged patients with symptoms or uncompleted PROs. Nurses tracked and called patients on receiving clinical or compliance alerts. The primary objective was to assess adherence (≥70% PRO completion per patient considered an adherent patient) in the first 2 months on the program. A secondary objective was to assess the positive predictive value (PPV) of the alerts to trigger recommendations.

Results: Forty patients were enrolled between August 2021 and September 2022. Median age was 64.5 years (range 29-79 years). Primary diagnosis was ovarian (75%), endometrial (17.5%), or cervical (7.5%) cancer, and 92.5% of patients were receiving systemic therapy. Median duration on the program was 55 days (range 8-121 days). The 2-month adherence was 65% (95% CI 50% to 80%) and the overall adherence was 60% (95% CI 43% to 75%). Sixty-five symptom-related alerts (75% severe, 25% moderate) were reported in 60% (24/40) of patients. There were 59 recommendations triggered by the alerts. The PPV of the alerts to trigger actions was 72% (95% CI 58% to 82%).

Conclusions: This pilot electronic malignant bowel obstruction monitoring program with real-time PRO assessment was feasible, and 65% of participants were adherent during the first 2 months on the program. The PRO response-based alerting system flagged concerning symptoms in 60% of participants, with a PPV of 72% to trigger nurse-led actions and/or management recommendations.

Trial registration number: NCT03260647.

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针对妇科癌症患者的电子恶性肠梗阻症状监测智能手机应用。

目标：玛格丽特公主癌症中心（Princess Margaret Cancer Centre）实施了一项跨专业计划，包括由护士主导的主动呼叫，为患有恶性肠梗阻的妇科癌症患者提供支持，与历史对照组相比，该计划的效果有所改善。该研究的目的是将主动呼叫转换为电子监控程序，以评估其在患有或可能患有恶性肠梗阻的妇科癌症患者中的可行性和可扩展性。方法："我的肠道追踪 "智能手机应用程序包括每周/每两周一次的电子患者报告结果（PRO）、教育材料和安全消息系统。根据患者报告结果的答案，警报系统会标记出有症状或未完成患者报告结果的患者。护士对收到临床或依从性警报的患者进行跟踪和呼叫。首要目标是评估患者在项目实施头两个月的依从性（每位患者的PRO完成率≥70%即为依从性患者）。次要目标是评估警报触发建议的阳性预测值（PPV）：40 名患者于 2021 年 8 月至 2022 年 9 月期间入组。中位年龄为 64.5 岁（29-79 岁）。主要诊断为卵巢癌（75%）、子宫内膜癌（17.5%）或宫颈癌（7.5%），92.5%的患者正在接受系统治疗。该计划的中位持续时间为 55 天（8-121 天不等）。两个月的坚持率为 65%（95% CI 为 50% 至 80%），总体坚持率为 60%（95% CI 为 43% 至 75%）。60%（24/40）的患者报告了 65 次症状相关警报（75% 为重度，25% 为中度）。警报触发了 59 项建议。警报触发行动的 PPV 为 72%（95% CI 58% 至 82%）：这项具有实时PRO评估功能的试验性电子恶性肠梗阻监测项目是可行的，65%的参与者在项目实施的头两个月中坚持了治疗。基于PRO反应的警报系统可提示60%的参与者出现相关症状，其PPV为72%，可触发由护士主导的行动和/或管理建议：试验注册号：NCT03260647。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Journal of Gynecological Cancer 医学-妇产科学

CiteScore

6.60

自引率

10.40%

发文量

280

审稿时长

3-6 weeks

期刊介绍： The International Journal of Gynecological Cancer, the official journal of the International Gynecologic Cancer Society and the European Society of Gynaecological Oncology, is the primary educational and informational publication for topics relevant to detection, prevention, diagnosis, and treatment of gynecologic malignancies. IJGC emphasizes a multidisciplinary approach, and includes original research, reviews, and video articles. The audience consists of gynecologists, medical oncologists, radiation oncologists, radiologists, pathologists, and research scientists with a special interest in gynecological oncology.